Although most occupational and physical therapists in an acute burn care setting use similar therapy practices, the time frames at which these therapeutic interventions are carried out vary according to the burn centers' practices. The purpose of this survey was to investigate current trends in burn rehabilitation and compare the results with a similar survey performed in 1994. The survey was designed in a similar fashion to the 1994 survey to ascertain common trends in burn rehabilitation. The survey was sent to 100 randomly selected burn care facilities throughout the United States and Canada. Content included rehabilitation interventions, including evaluation, positioning, splinting, active range of motion, passive range of motion, ambulation, as well as the cross-training of therapists. Significant increases in the percentages of burn centers initiating common therapy practices were found. Positioning (41% increase), active range of motion (48% increase), passive range of motion (52% increase), and ambulation (29% increase) were all found to have increases in the number of burn centers employing these practices in the same time frame. Overall comparison from 1994 to 2006 shows that common therapy techniques are being initiated earlier in the patient's acute burn stay. These results are consistent with recent medical trends of earlier acute discharges and more focus on outpatient rehabilitation.
OBJECTIVE: To determine how precisely asymptomatic subjects can reproduce a neutral zero position of the head. STUDY DESIGN: Repeated measures of the active cervical neutral zero position. SETTING: Institute of Medical Biology (Center of Biomechanics) at Odense University. PARTICIPANTS: Thirty-eight asymptomatic students from the University of Odense, male/female ratio 20:18 and mean age 24.3 years (range, 20 to 30 years). INTERVENTION: Measurements of the location of the neutral zero head position by use of the electrogoniometer CA-6000 Spine Motion Analyzer. Each subject's neutral zero position with eyes closed was measured 3 times. The device gives the localization of the neutral zero as coordinates in 3 dimensions (x, v, z) corresponding to the 3 motion planes. RESULTS: The mean difference from neutral zero in 3 motion planes was found to be 2.7 degrees in the sagittal plane, 1.0 degree in the horizontal plane, and 0.65 degree in the frontal plane. CONCLUSION: We found that young adult asymptomatic subjects are very good at reproducing the neutral zero position of the head. This suggests the existence of some advanced neurologic control mechanisms.
We investigated, by studying medical records, background factors and consequences of accidental falls of patients 65-74 years who attended the Department of Orthopedics' emergency clinic in Lund. We also assessed possible prevention measures. Fractures occurred in three quarters of the registered falls. Women were more prone to sustain fractures than men. Forearm fractures were commonest among women while hip fractures were commonest among men. One third of the patients were admitted to an orthopedic ward because of the fall. The patients who were less healthy had sustained fractures oftener and also needed more hospital care. Information regarding risk factors for falls and fractures were often missing in the patients' medical records. Impaired walking and balance, and medication increased the risk of falls. Such patients constitute a high risk group for future falls and fractures. A newly developed instrument is suggested as a routine in the emergency department to increase the awareness of risk factors for falls in the elderly. Satisfactory documentation is a prerequisite for further treatment and referrals to prevent falls and fractures.
Prolonged occupational standing has previously been associated with low back pain (LBP) development. The immediate effects of a bout of prolonged standing on subsequent functional movement performance have not been investigated. It is possible that including a period of prolonged standing may have acute, detrimental effects. The purpose of the study is to investigate the impact of a prolonged standing exposure on biomechanical profiles (trunk muscle activation, joint stiffness and kinematics) during three functional movements. A total of 23 volunteers without history of LBP performed lumbar flexion, single-leg stance and unloaded squat movements pre- and post 2 h of standing exposure. It was found that 40% of the participants developed LBP during the standing exposure. There was a decrease in vertebral joint rotation stiffness in lateral bending and increased centre of pressure excursion during unilateral stance following standing exposure. There may be adverse effects to prolonged standing if followed by activities requiring precise balance or resistance of side loads. STATEMENT OF RELEVANCE: Prolonged standing may result in decreases in balance reactions during narrow base conditions as well as in the capacity to effectively resist side-loads at the trunk. Consideration should be given when prolonged standing is included in the workplace.
Clinical measures of seated postural control in adults are not standardized and most are derived from in-house tools. The purpose of this study is to adapt a pediatric instrument to evaluate seated postural control in adult wheelchair users.
The new instrument is called the Seated Postural Control Measure for Adults (SPCMA) 1.0. Five preliminary versions were pretested with some 20 adults by two raters and a group of experts.
This instrument comprises three sections: Section 1, level of sitting scale for adults (1 item, 7-point ordinal scale); Section 2, static postural alignment (22 items, 7-point ordinal scale); and Section 3, postural alignment after a dynamic activity, propulsion of the wheelchair on flat terrain and an incline (22 items, 7-point ordinal scale).
The SPCMA for Adults 1.0 improves the quality and uniformity of evaluations done by different raters, which facilitates more rigorous follow-up of clients over time, communication between professionals, and objective verification of the attainment of intervention objectives.
In this study, dealing with the early diagnosis and prevention of back pains, adolescent postural faults especially in the sagittal plane were examined with a standardized physical examination technique suitable for use in schools; the strength and flexibility of muscles affecting the back were investigated; neck and/or back symptoms were screened; and the association of background factors and the findings of the physical examination with symptoms was evaluated. The material consisted of a total of 370 11, 13, 15 and 17-year-old comprehensive and senior secondary school pupils from a small suburban municipality, selected by random sampling. The subjects were quite evenly distributed in terms of different age and sex groups. The physical examination of the back, with evaluation of symptoms, took place in the autumn of 1981 in the premises of school health care, and 58 of the examined subjects were referred on the basis of symptoms and/or findings to an X-ray examination of the thoracic and/or lumbar spine. The X-rays were taken in the spring of 1982. 1 Back pain history. Relation between present neck and/or back symptoms, background variables and findings in physical examination. 7.6% of the subjects reported previous neck and/or back symptoms that had interfered with their school work or leisure activities. Present, mainly mild neck and/or back symptoms were reported by 19.7%. Girls reported symptoms more often than boys (p less than 0.05), and the occurrence of symptoms increased with age (p less than 0.001). Roughly one third of the subjects had frequent symptoms. Pains were most often localized in the low back (p less than 0.001) and were most frequently associated with sitting or physical activities. Most subjects who had suffered from previous symptoms also reported symptoms at the time of the study. These more chronically symptomatic subjects accounted for 6.2% of the total material. 2.9% of siblings under 11 years, 8.0% of siblings 11-17 years, and 13.7% of siblings over 17 years of age had at some time prior to the study complained of recurrent neck and/or back symptoms. Of mothers, 19.0% and of fathers, 15.4% reported neck and/or back symptoms that were continual and/or reduced working ability. The mother (p less than 0.01) and/or the father (p less than 0.05) of a subject reporting frequent symptoms, also reported neck and/or back symptoms.(ABSTRACT TRUNCATED AT 400 WORDS)
Laboratory of Muscular Activity Physiology, Institute of Age Physiology, RAS, Department of Anatomy and Sport Morphology, Russian State Academy of Physical Culture, Moscow.
Longitudinal study of forming of the posture was performed in 138 healthy pupils of Moscow school No. 710 aged from 6.5 to 14 of both sexes. Simultaneously children were examined anthropometrically and their constitution was determined after Schtefko. The posture was examined visually. It was established that posture forms within observation terms depending on sex, age and somatotype. Peak age for the risk of posture disturbance is 9-11 for girls and 10-12 for boys. Digestive and muscular somatotypes provide favourable prognosis respective to posture (in girls), while astenoid somatotype is the worst. Special type of posture defect is characteristic for each somatotype. In children with digestive and muscular somatotype primary posture defects disappear by 12-14. In children with astenoid and thoracal somatotype their number, in contrary, grows.
In order to test the hypothesis about rapid involution of functional parameters in residents in the Polar region, the functional parameters in men of 20-69 years have been compared in cross-sectional study. There is a tendency to a steady decrease of height, strength indices, parameter of muscle working capacity, balancing of the body when standing on one leg, vital capacity, cardiac output, tolerance to hypoxemia, level of physical health, adrenocorticotropic hormone and testosterone levels and an increase of body mass index, index of coordination (impairment of motor coordination), time of visual-motor response, systolic and diastolic blood pressure, index of functional changes, insulin level. More pronounced decline of functions is observed in men after 50 years.
